Health policies and data

Health Inequalities

Large inequalities in health status and life expectancy exist across population groups and within the OECD countries. These inequalities in health status are linked to many factors, including differences in exposure to health risk factors and in access to health care.

Most OECD countries have endorsed, as major policy objectives, the reduction of inequalities in health status and the principle of equal access to health care based on need. The OECD regularly monitors to what extent these policy objectives are achieved, as well as the potential benefits and costs of various policy interventions that might help reduce health inequalities

How will future retirees fare? The OECD report Preventing Ageing Unequally examines how the two global megatrends of population ageing and rising inequalities have been developing and interacting, both within and across generations. Taking a life-course perspective the report shows how inequalities in education, health, employment and income interact, resulting in large lifetime differences across different groups. The report points to strong policy complementarities and synergies and thus a whole-of-government approach is likely to be much more effective than a series of separate inequality reducing policies. In particular, to ensure a better retirement for all, policies have to be coordinated across family, education, employment, social ministries and agencies.

Good health is a key aspect of people’s well-being and enhances opportunities to participate in the labour market and to benefit from economic and employment growth. People with poor physical or mental health are less likely to work and more likely to be unemployed than people in better health. The relationship also works the other way around: people with higher level of education and higher income tend to be in better health and live longer than those with lower level of education and income. Greater emphasis on public health and disease prevention, along with improved access to health services, can improve the health status and life expectancy of disadvantaged groups, and also increase their employment rates and social inclusion.

Inequalities in health status are due to many factors, including differences in living and working conditions and in behavioural factors. Lifestyle behaviours (such as nutrition habits, physical inactivity, obesity, smoking and alcohol drinking) are important risk factors for many diseases including diabetes, cardiovascular diseases and cancers. People in lower socioeconomic groups are more likely to smoke, be obese and be exposed to other important behavioural risk factors. Greater efforts targeting modifiable behavioural risk factors among disadvantaged groups can play an important role in promoting healthier lifestyles, offering individuals better choices, and reducing health inequalities.

Nearly all OECD countries have achieved universal (or almost universal) health coverage for a core set of health services and goods, except a few countries such as Mexico and the United States which have both taken important steps in recent years to expand health coverage and reduce the number of uninsured people.Still, inequalities in access to care exist across different socio-demographic groups, including by sex, age, geographic area and socio-economic status, for financial and non-financial reasons (including a shortage of health care providers in certain geographic areas).Findings from OECD work highlight the importance of ensuring proper health insurance coverage for essential health services for all the population, as well as proper geographic distribution of health services across different regions in each country, to ensure effective access to care.